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diagnosis hepatology differential ascites microscopy nephrology urine clinical gradient algorithm causes granular serum interpretation laboratory liver management muddybrown pathophysiology table
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG) SAAG ≥ 1.1: • Cirrhosis • Portal
Serum Ascites Albumin ... Gradient (SAAG) ... thrombosis • Late budd-chiari ... obstruction • Early budd-chiari ... #Table #Serum #Albumin
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
serum ascites albumin ... gradient (SAAG) ... Cirrhosis, Late Budd-Chiari ... pericarditis, Early Budd-Chiari ... #ascites #albumin
Deciphering the SAAG - Serum to Ascites Albumin Gradient Ascites is either made in the liver sinusoid
Deciphering the SAAG ... Serum to Ascites Albumin ... fibrosis) High SAAG ... oncotic pressure Low SAAG ... Diagnosis #Hepatology #SAAG
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... Brown” Casts on ... Finely granular cast ... coarser granular cast ... coarse (c) and muddy
Ascites - Differential Diagnosis and Workup Algorithm • Perform paracentesis: • Cell count and diff • Total
protein • Fluid albumin ... and serum albumin ... • Calculate SAAG
Muddy Brown Granular Casts three ways - Brightfield, Darkfield, Phase Contrast. Dr. Vipin Varghese @vipvargh #Muddy #Brown #Granular
Muddy Brown Granular ... Casts three ways ... Varghese @vipvargh #Muddy ... Brown #Granular #Casts
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy - Casts ... Acellular Casts ... • Hyaline Casts ... • "Muddy Brown ... " Casts - Strongly
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
hypertension (SAAG ... insufficiency - Budd-Chiari ... Hypoalbuminemia (SAAG ... - Myxedema (SAAG ... Diseased Peritoneum (SAAG
Examples of varying granular and granular/waxy mixed casts: A: coarse granular/broad-waxy (and surrounding white blood cells);
granular/waxy mixed casts ... light granular/muddy ... granular, C and D: muddy ... Granular #MuddyBrown #Casts
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
Serum Ascites Albumin ... Gradient (SAAG) ... Diagnosis High albumin ... vein thrombosis (Budd-Chiari ... ischemia/infarction #SAAG
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